Publications by authors named "Alexandre J Vivanti"
Article Synopsis
- The study aimed to assess the effectiveness of RCR-cfDNA testing for detecting common autosomal trisomies in twin pregnancies compared to singleton pregnancies.
- It involved a multicenter analysis of 862 twin pregnancies, focusing on the rate of no-call results and the accuracy of detecting trisomy 21, 18, and 13.
- Results showed that the RCR-cfDNA test achieved 100% accuracy for detecting all trisomies with a low no-call rate in twin pregnancies, indicating its reliability as a first-tier screening option.
Article Synopsis
- Neonatal herpes simplex virus (HSV) infection is rare but has high mortality and morbidity rates, especially in infants under 6 weeks old, with a retrospective study in France revealing an incidence of 5.5 cases per 100,000 live births over 10 years.
- The predominant serotype found was HSV-1, and many cases were attributed to post-natal transmission through the orolabial route, with early diagnosis and treatment via acyclovir significantly improving outcomes for asymptomatic infants.
- Key risk factors identified for poor outcomes included being born to HSV-seronegative mothers and being preterm, highlighting the need for better understanding and management of HSV infections in neonates.
Perinatal outcomes between immediate vs deferred selective termination in dichorionic twin pregnancies with fetal congenital anomalies: a French multicenter study.
Am J Obstet Gynecol MFM
June 2024
Article Synopsis
- A study was conducted to compare perinatal outcomes between immediate and deferred selective termination of discordant twin pregnancies with anomalies, considering the risk of pregnancy loss.
- The results showed that the deferred selective termination group had a 100% survival rate for the healthy co-twin, while the immediate group had a 93.8% survival rate (P<.01).
- Additionally, the rate of preterm birth was significantly lower in the deferred group (20.2%) compared to the immediate group (66.7%), indicating more favorable outcomes with delayed procedures.*
Article Synopsis
- The study investigates the effects of SARS-CoV-2 infection in pregnant women during their 2nd and 3rd trimesters, focusing on outcomes for both mothers and newborns during the first two COVID-19 waves in Paris from April 2020 to January 2021.
- Conducted in 10 maternity hospitals, the research included 2,410 pregnant women, with 310 testing positive for the virus, mostly around 28 to 37 weeks of gestation, and found that many could be treated as outpatients, while 23% required hospitalization.
- Key findings revealed that multiparous women were more likely to have serious outcomes such as preterm delivery and an
Article Synopsis
- The study investigates the effectiveness of cell-free DNA (cfDNA) testing for detecting fetal aneuploidies in women with triplet pregnancies, as current data is limited compared to singleton pregnancies.
- The research involved a retrospective analysis of 255 women who underwent cfDNA testing between 2017 and 2020, focusing primarily on trisomy 21 (T21) and secondarily on trisomy 18 (T18) and trisomy 13 (T13).
- Results indicated that cfDNA testing can serve as a primary screening tool for major fetal aneuploidies in triplet pregnancies, highlighting the importance of informed patient consent before proceeding with the test.
Prenatal diagnosis of isolated bilateral clubfoot: Is amniocentesis indicated?
Acta Obstet Gynecol Scand
January 2024
Article Synopsis
- This study evaluates the effectiveness of cytogenetic testing through amniocentesis in fetuses diagnosed with isolated bilateral talipes equinovarus after an ultrasound.
- It involved a retrospective analysis of 214 cases, where various prenatal data and outcomes were tracked from five fetal medicine centers between 2012 and 2021.
- The results indicated that the majority of cases had normal genetic outcomes, with a high live birth rate, but three medical terminations occurred due to significant genetic disorders detected through testing.
Article Synopsis
- In 2020, the SARS-CoV-2 virus emerged in China, posing significant health risks, especially for pregnant women, leading to complications that can increase maternal and neonatal mortality.
- Research indicated potential maternal-fetal transmission of the virus and identified placental abnormalities, termed placentitis, which could disrupt placental functions and fetal heart rate monitoring.
- A study analyzed data from 17 mothers with SARS-CoV-2 infections; through this, clinicians discovered a high incidence of coagulopathy in mothers and noted that all fetuses were delivered through emergency cesarean sections, with one neonatal death recorded due to complications related to the infection.
Background: The occurrence of COVID-19 during the pregnancy can cause several negative maternal and neonatal outcomes. Nasopharyngeal viral load is associated with inflammatory markers and might influence the disease severity in non-pregnant patients, but there are no data about the relationship between viral load and perinatal outcomes in pregnant patients.
Objective: To investigate the hypothesis that nasopharyngeal SARS-CoV-2 load (estimated with real-time polymerase chain reaction delta cycle (ΔCt), measured in hospital clinical laboratories) is associated with perinatal outcomes, when COVID-19 is diagnosed in the third trimester of pregnancy.
Management and survival of foetuses with trisomy 18 in a French retrospective cohort.
J Gynecol Obstet Hum Reprod
April 2023
Objectives: The main objective of this study was to evaluate parents' current demands following the announcement of trisomy 18 and maternal risks.
Material And Methods: A single-centre retrospective study was performed in the Paris Saclay Foetal Medicine Department from 2018 to 2021. All patients followed up in the department who had cytogenetic confirmation of trisomy 18 were included.
Objective: This study aimed to describe the characteristics of fetal demise after SARS-CoV-2 infections and clarify whether it is associated with clinical severity, placental lesions, or malformations or due to actual fetal infections.
Data Sources: PubMed and Web of Science databases were searched between December 1, 2019, and April 30, 2022.
Study Eligibility Criteria: Cohort, cross-sectional, and case-control studies and case series or case reports describing stillbirths or late miscarriages (ie, pregnancy loss occurring between 14 and 22 weeks of gestation, before and after the onset of labor) from mothers with SARS-CoV-2 infection during pregnancy (demonstrated by at least 1 positive real-time reverse transcription-polymerase chain reaction from nasopharyngeal swabs and/or SARS-CoV-2 placental infection).
Article Synopsis
- A vanishing twin (VT) occurs in about 30% of twin pregnancies and is linked to a higher risk of fetal genetic abnormalities (aneuploidy).
- A study analyzed data from 847 VT patients who underwent noninvasive prenatal testing (NIPT) for common fetal trisomies, alongside comparison groups of singleton and viable multiple pregnancies.
- Results showed that while NIPT was effective in screening for trisomy 21 (with a 50% confirmation rate), caution is advised for interpreting results for trisomies 18 and 13, suggesting ultrasound monitoring instead of invasive tests.
(1) Background: What is the role of serum CMV PCR in the diagnosis of recent primary infection (PI) in pregnant women when IgG avidity is uninformative? (2) Methods: Retrospective cohort study to compare serum versus whole blood CMV PCR. (a) Qualitative assessment: CMV PCR was performed on 123 serum samples and 74 whole blood samples collected from 132 pregnant women with recent CMV PI. PCR positivity rate was used to calculate sensitivity in serum and whole blood.
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- Growing interest in neurodevelopmental disorders and advances in chromosomal microarray analysis have led to increased identification of neuro-susceptibility copy number variations (CNVs) with incomplete penetrance and variable expressivity, making detection tricky.
- The French research group "AchroPuce" has identified 17 specific CNVs that are considered significant in this context and has shaped current postnatal healthcare practices, but there's still no consensus for prenatal diagnosis.
- A survey of 121 French health professionals revealed strong support for reporting these PIEV CNVs to patients before birth, emphasizing the need for multidisciplinary consultation as a key approach for better recommendations in prenatal care and genetic counseling.
Background: To assess changes in the number and profile of in utero transfer requests during the first lockdown.
Methods: An observational, retrospective, cohort study. All pregnant women, from the Paris area (France), for whom a request for in utero transfer to the transfer unit was made during the first lockdown in France (from 17 March to 10 May 2020) or during a mirror period (years 2016 to 2019) were included.
Article Synopsis
- The study investigates the effectiveness of a half-dose of antenatal betamethasone (11.4 mg) compared to the standard full dose (24 mg) in preventing respiratory distress syndrome in preterm infants while minimizing potential side effects.
- It is a randomized, double-blind, placebo-controlled trial conducted in 37 perinatal centers in France involving pregnant women at risk of preterm delivery who had already received the first injection of the medication.
- The primary outcome measured was the need for additional surfactant treatment within 48 hours of birth, with the researchers aiming to demonstrate that the half dose was non-inferior to the full dose based on specific statistical criteria.
Article Synopsis
- The study aimed to assess whether using cervical dilators alongside misoprostol could shorten labor during second-trimester pregnancy terminations.
- Conducted as a randomized controlled trial, it involved 347 women, comparing outcomes such as labor duration and side effects between those receiving cervical dilators and those getting misoprostol alone.
- Results showed no significant differences in labor duration or complications between the two groups, suggesting that the addition of cervical dilators did not effectively shorten labor.
Vein of Galen aneurysmal malformation (VGAM) is a severe rare vascular anomaly whose prognosis depends on cerebral and cardiac consequences that can be hard to diagnose, let alone predict in utero. We performed an updated review to summarize current research on the genetics, ultrasound and MRI of VGAM that could help in the diagnosis and management of VGAM. Prenatal diagnosis of VGAM has greatly improved in recent years.
View Article and Find Full Text PDFImpact of SARS-CoV-2 Alpha and Gamma Variants among Symptomatic Pregnant Women: A Two-Center Retrospective Cohort Study between France and Brazil.
J Clin Med
May 2022
New variants of SARS-CoV-2 are a major source of concern, especially for pregnant women and in the perinatal context. The primary aim of this study was to compare the severity of COVID-19 infection in pregnant women depending on strain predominance between wild-type Alpha and Gamma variants. The secondary aim was to study the impact of these strains on obstetrical and neonatal outcomes.
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